Basic Information
| Provider Information | |||||||||
| NPI: | 1750642948 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUERGER | ||||||||
| FirstName: | KELLY | ||||||||
| MiddleName: | JOANNE | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 MEADOWS BLVD | ||||||||
| Address2: | |||||||||
| City: | CASTLE ROCK | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801098405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204550650 | ||||||||
| FaxNumber: | 7204550057 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 W 16TH ST | ||||||||
| Address2: | |||||||||
| City: | PUEBLO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 810032745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195844000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2012 | ||||||||
| LastUpdateDate: | 10/19/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4233 | CO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.